GP practices could face legal action from physician associates (PAs), as the profession’s trade union has revealed plans to take forward 184 individual employment claims.
The organisation United Medical Associate Professionals (UMAPs) claimed there have been around 200 PA redundancies from surgeries since October as a result of ‘discriminatory’ scope guidance produced by both the BMA and the RCGP.
UMAPs, which became a trade union in December, said it has ‘empowered’ affected PA members to ‘initiate legal proceedings’ against practices that have ‘used such guidance to justify dismissals, breaches of contract, or redundancies’.
The union’s chief executive officer Stephen Nash said it is currently ‘considering advancing 184 cases’, all of which would be against GP practices.
Last October, UMAPs warned GP partners that use of ‘restrictive’ scope documents could result in legal challenges, while also unveiling plans to take legal action directly against the RCGP for ‘harm’ caused by the college’s PA scope of practice.
UMAPs told our sister title Pulse that its legal approach will now be to ‘empower colleagues who are affected by this to make an employment tribunal claim against their employer, adding the RCGP and the BMA as potential second respondents where appropriate’.
Its claim of 200 PA redundancies came from a ‘snap survey’ carried out in December, which received 387 PA responses, of which 196 had been ‘affected’ – meaning they had been dismissed or their scope of work ‘materially and adversely altered’ – while 81 said they had been ‘summarily dismissed’ from GP practices.
Mr Nash said: ‘Additionally, we have begun incorporating cases we were already working on, which did not participate in the survey, into our dataset as their internal processes conclude.
‘This has pushed the total cases beyond 200, though the final count is yet to be determined.’
He also said UMAPs hopes that ‘highlighting the ongoing damage’ will have a ‘meaningful impact’ on cases currently being ‘addressed through internal processes’, which will ultimately reduce ‘the number of cases escalating to ACAS or employment tribunals’.
UMAPs has also claimed that redundancies have disproportionately affected women and ethnic minority PAs, based on results from the snap survey.
It found that 46% of white respondents reported being affected compared to 66% of black respondents and 56% of Asian respondents, according to UMAPs.
The organisation’s statement, posted late December, said: ‘UMAPs has empowered affected members to initiate legal proceedings against organisations that have issued and/or acted upon discriminatory policies.
‘Employers and medical institutions that have used such guidance to justify dismissals, breaches of contract, or redundancies will be named as respondents in employment tribunal cases. This includes targeting organisations producing “non-legally binding” guidance documents designed to restrict MAP roles unjustifiably.
‘UMAPs has already begun advancing cases through its legal team to ACAS, ensuring that members have a pathway to justice.’
In response to this, the BMA said that patient safety should be ‘the first thing any NHS employer thinks about in its hiring practices’.
A spokesperson continued: ‘With multiple documented cases of patient harm due to PAs being employed in unsuitable roles as well as vocal concerns across the medical profession having now led to an ongoing Government review, it is absolutely right that clear national scopes of practice are set out to prevent further unintentional harm.
‘Attempting to challenge these safety policies, as this legal action appears to be trying to do, would seem a baffling and wrong-headed approach. However, we await further details of the case.’
The RCGP said that it was aware of UMAPs’ recent statement and ‘will engage as appropriate in due course’.
A spokesperson said: ‘We wish to reiterate that the RCGP guidance on PAs is advisory. It covers induction and preceptorship, supervision, and scope of practice and aims to support GP practices and current employers of PAs.
‘We have always been clear that it is for employers to decide whether to follow our guidance and that it is their responsibility to ensure the appropriate treatment and handling of existing PA contracts.’
‘The RCGP is strongly committed to equality, diversity and inclusion, and this is key to our values as an organisation,’ the college added.
Its scope document, published in October, stipulated that PAs in general practice must not see patients who have not been triaged by a GP, nor patients who present for a second time with an unresolved issue.
The college advised practices that while it cannot ‘enforce’ the guidance – as this is down to employing GPs to decide – it ‘may be taken into account’ by NHS Resolution and medical defence organisations in clinical negligence cases.
Meanwhile, the GMC, which started regulating PAs from last month, has been clear that it will not set out a scope of practice for these professionals itself, but will ‘have reference’ to scopes set out by other bodies.
A version of this article was first published by our sister title Pulse
